Provision Of Occupational Health Services Research Articles

Characteristics of Multiprofessional and Client-Oriented Approach in Occupational Health Services: A Cross-Sectional Survey Among Occupational Health Professionals.

Multiprofessional and client-oriented approaches are considered key factors for successful occupational health services, and for impressive occupational health cooperation between a client organisation and occupational health service provider. The purpose of this study was to find out the views of occupational health physicians, occupational health nurses, occupational physiotherapists, and occupational health psychologists about multiprofessional and client-oriented working methods. These working methods describe the guidelines for good occupational health practice in Finland, also serving the framework of the present study. The survey was conducted in May and June 2022. The data consisted of answers to open-ended questions of a larger questionnaire. The data was analysed with the method of theory-related thematic analysis. Seven occupational health service providers committed to the study. Altogether 121 professionals responded to the question surveying the multiprofessional approach, and 119 professionals responded to the question of client-oriented approach. The results showed that both the multiprofessional and client-oriented approaches are closely related to each other, and the views of these approaches are in line with the good occupational health practice. Multiprofessional approach was most commonly described with the theme of sharing expertise. Respectively, the theme of smooth cooperation most commonly described the client-oriented approach. At its best, the answers showed that a multiprofessional working strategy takes into account the expertise of different professionals so that the client can be offered high-quality, accurate content and timely occupational health services. The results provide up-to-date information on working strategies of occupational health services in Finland. The results can be used in further development of multiprofessional and client-oriented work in occupational health services.

The use of digital occupational health services among employer customers: A cross-sectional study

Occupational health (OH) service providers, together with their client organizations co-operate in promoting health and work ability. Alongside with the so-called traditional services, more and more digital services are offered by OH service providers. However, little is known how the employer customers experience and use digital OH services. This study evaluates the types of digital OH services employer customers use and how they assess the usefulness and ease of use of these digital services. Furthermore, the aim is to find out factors associated the usefulness and ease of use. To determine these features of usefulness and ease of use of digital services the Technology Acceptance Model was utilized. A cross-sectional, electronic survey was carried out to the members of human resources (HR) and entrepreneur associations between December 2022 and January 2023. The survey was in Finnish. The research material consisted of the employer customers’ answers to the multiple-choice questions of the use, usefulness and ease of use of digital OH services. The data was analyzed by quantitative statistical analysis. A total of 455 respondents took part in the study, comprising 198 representatives of HR professionals and 257 entrepreneurs. Most of the respondents were women (65%) and over 50 years old (61%). HR professionals rated their information and communications technology skills significantly more often good or really good compared to the entrepreneurs, being 92 % and 62 %, respectively. The most frequently utilized digital OH services were the ability to update personnel’s information in the OH patient registry (48.0%) and remote action plan negotiations (37.1%). Less than one-third of the respondents (29.9%) took part in remote work ability negotiations, while approximately one-fifth (20.8%) participated in remote workplace surveys. In general, the HR professionals used digital OH services more frequently and estimate the usefulness and the use of digital OH services more positively compared to the entrepreneurs (p<0.05). The study produced new information of the use and experiences of using digital OH services among the employer customers. The findings can be used to optimize the delivery and effectiveness of digital OH services for all employer customers, especially for the entrepreneurs who seemed be less used to utilize digital services.

Facilitating the Movement of Knowledge in Occupational Health Services

This article examines the establishment and maintenance of structures and relationships within interorganizational collaborations, specifically focusing on occupational health services in Sweden. It investigates how these collaborations are adjusted to existing structures to facilitate the movement of knowledge. The study draws attention to the gaps or seams (Vertesi, 2014) that arise when occupational health services providers and employers have different interests and objectives concerning occupational health and safety and explores the continuous and often unnoticed relational work (Zelizer, 2012) undertaken by occupational health services providers to make their expertise and services relevant and appealing to customers and employers. This article contributes to the ongoing discussion on alignment work (Kruse, 2021, 2023) by highlighting its current limitations and underscoring the importance of relational work in creating the necessary conditions for moving knowledge.

Framework of inter-professional values and professionalism competencies of occupational health service team members

Introduction: The present study aimed to develop the framework of inter-professional values and professionalism competencies in occupational health services.
 Materials and Methods: This study was carried out at Shahid Sadoughi University of Medical Sciences, Yazd, in 2018-2018. In the first step, the framework of professionalism and inter-professional competencies in different disciplines was reviewed. In the second step, the competencies and expectations of inter-professional professionalism were assessed through the viewpoints of participants through a focus group method. After that, the explored data was refined based on the principles of competency development. The initial version of the inter-professional professionalism framework was reviewed from the perspective of different stakeholders. 
 Results: In the first step, 39 competencies were explored. In the second phase, 12 competencies were proposed and added to the framework. The inter-professional values and professionalism competency framework was explained with 51 competencies in six areas of altruism, justice, accountability, excellence, respect, and integrity.
 Conclusion: Providing occupational health services is complex activities that were influenced by multiple stakeholders. Explaining the components of inter-professional professionalism in six core domains as a road map would assist occupational health service providers.

Partial Ideas for Improving the Legal Regulation of Assessment of Competence to Work

This paper deals with medical examination of employee’s ability to work. Although from a legislative-technical point of view, this regulation is considered to be successful, in practice it causes major problems in the area of assessment care, which is evidenced in particular by the case law. Referencing to practice, we can state that the idea of the occupational health services provider as professional assistant of the employer in providing for the protection of employees’ occupational health has not taken hold at all. Employers justifiably ask why they should pay for a medical report giving them no legal certainty. Employers, on the other hand, want to pay for services that give them a solid basis for further action against employees. From the analysed regulations, it is clear that the issue of health assessment and medical reports remains in some respects still gaping, both in terms of the nature of the medical report and in terms of accepting the lack of work capacity of providers of occupational health services.

Company Representatives' Experiences of Occupational Health Surveillance for Workers Exposed to Hand-Intensive Work: A Qualitative Study.

Exposure assessment seldom precedes the medical health checks in occupational health surveillance. In order to emphasize the interconnection between exposure assessment and medical health checks, a process model was developed. The process model aimed to guide employers and Occupational Health Service providers through the execution of occupational health surveillance. The objective of this qualitative study is to explore company representatives’ experiences of the process model, in terms of feasibility and values, and to identify factors that facilitate or impede the process. Thirty-three company representatives from ten companies were interviewed. Interviews were analyzed using content analysis. The company representatives experienced that the model contributed to increased risk awareness and understanding of the exposure effects on workers’ health. They valued the exposure assessments performed by an ergonomics expert, which led to the discovery of previously unidentified risks. The feasibility was facilitated by: a joint start-up meeting in which the process was planned, clear communication between the involved parties, and clarity regarding the process ownership. The findings reveal that a guiding process model is valuable for the execution of occupational health surveillance. However, the model should not only define the components included; a practical guide concerning how the process can be executed is also needed.

Collaboration between employers and occupational health service providers: a systematic review of key characteristics

BackgroundEmployees are major contributors to economic development, and occupational health services (OHS) can have an important role in supporting their health. Key to this is collaboration between employers and OHS. We reviewed the evidence regarding the characteristics of good collaboration between employers and OHS providers that is essential to construct more effective collaboration and services.MethodsA systematic review of the factors of good collaboration between employers and OHS providers was conducted. We searched five databases between January 2000 and March 2016 and back referenced included articles. Two reviewers evaluated 639 titles, 63 abstracts and 20 full articles, and agreed that six articles, all on qualitative studies, met the predetermined relevance and publication criteria and were included. Data were extracted by one reviewer and checked by a second reviewer and analysed using thematic analysis.ResultsThree themes and nine subthemes related to good collaboration were identified. The first theme included time, space and contract requirements for effective collaboration with three subthemes (i.e., key characteristics): flexible OHS/flexible contracts including tailor-made services accounting for the needs of the employer, geographical proximity of the stakeholders allowing easy access to services, and long-term contracts as collaboration develops over time. The second theme was related to characteristics of the dialogue in effective collaboration that consisted of shared goals, reciprocity, frequent contact and trust. According to the third theme the definition of roles of the stakeholders was important; OHS providers should have competence and knowledge about the workplace, become strategic partners with the employers as well as provide quality services.ConclusionAlthough literature regarding collaboration between the employers and OHS providers was limited, we identified several key factors that contribute to effective collaboration. This information is useful in developing indicators of effective collaboration that will enable organisation of more effective OHS practices.

Exploring Challenges to Primary Occupational Health Care Service for Informal Sector Workers

Informal sector workers are a significant part of the Thai workforce but occupational health service provision for them is under-developed. This multi-method study investigated occupational health policies and service provision in 10 primary health units in four north eastern Thailand provinces. Questionnaires, in-depth interviews and focus group discussions were used to collect data. Descriptive statistics and content analysis were used to analyse quantitative and qualitative data respectively. Results showed limited policy and budget support for such services. Even though service providers’ occupational health knowledge overall was good, only two of the units provided such services. They were notable for very good functional relationships with their local administration organizations, community and worker leadership and village health volunteers, plus strong staff commitment to support workers health in their own communities. We suggest that enhancing primary care services for worker health and safety requires development of stronger policy directives, budget provision and management support.

Occupational Health Services Integrated in Primary Health Care in Iran

IntroductionA healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. MethodsTo describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. FindingsIran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. ConclusionsIran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health professionals are recommended.

Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania

IntroductionOccupational health and safety is related with economic activities undertaken in the country. As the economic activities grow and expand, occupational injuries and diseases are more likely to increase among workers in different sectors of economy such as agriculture, mining, transport, and manufacture. This may result in high occupational health and safety services demand, which might be difficult to meet by developing countries that are prioritizing economic expansion without regard to their impact on occupational health and safety. ObjectiveTo describe the status of occupational health and safety in Tanzania and outline the challenges in provision of occupational health services under the state of an expanding economy. FindingsTanzania's economy is growing steadily, with growth being driven by communications, transport, financial intermediation, construction, mining, agriculture, and manufacturing. Along with this growth, hazards emanating from work in all sectors of the economy have increased and varied. The workers exposed to these hazards suffer from illness and injuries and yet they are not provided with adequate occupational health services. Services are scanty and limited to a few enterprises that can afford it. Existing laws and regulations are not comprehensive enough to cover the entire population. Implementation of legislation is weak and does not protect the workers. ConclusionsMost Tanzanians are not covered by the occupational health and safety law and do not access occupational health services. Thus an occupational health and safety services strategy, backed by legislations and provided with the necessary resources (competent experts, financial and technological resources), is a necessity in Tanzania. The existing legal provisions require major modifications to meet international requirements and standards. OHS regulations and legislations need refocusing, revision, and strengthening to cover all working population. Capacities should be improved through training and research to enable enforcement. Finally the facilities and resources should be made available for OHS services to match with the growing economy.

Is the British Army medical grading functional assessment tool effective?

Decision Support Aids (DSAs) have been widely used throughout industry and one (known as Table 7) is available to support British Army Medical Officers (MOs) grade soldiers against the Joint...

The influence of social capital on employers' use of occupational health services: a qualitative study.

BackgroundOccupational health services may have a strategic role in the prevention of sickness absence, as well as in rehabilitation and return to work after sick leave, because of their medical expertise in combination with a close connection to workplaces. The purpose of this study was to explore how employers and occupational health service providers describe their business relations and the use of occupational health services in rehabilitation in relation to the organization of such services. The study uses a theoretical framework based on social capital to analyse the findings.MethodsInterviews and focus groups with managers with Swedish public employers (n = 60), and interviews with occupational health services professionals (n = 25).ResultsEmployers emphasized trustful relationships, local workplace knowledge, long-term contracts and dialogue about services for good relationships with occupational health providers. Occupational health providers strove to be strategic partners to employers, promoting preventive work, which was more easily achieved in situations where the services were organized in-house. Employers with outsourced occupational health services expressed less trust in their providers than employers with internal occupational health provision.ConclusionsSocial capital emerges as central to understanding the conditions for cooperation and collective action in the use of occupational health services, with reference to structural (e.g. contracts), relational (e.g. trust) as well as cognitive (e.g. shared vision) dimensions. The study suggests that attention to the quality of relationships is imperative for developing purposeful occupational health service delivery in rehabilitation and return to work.

Perceptions of health workers regarding the occupational health services rendered at Onandjokwe hospital, Namibia

Objective: Health care workers are exposed to a variety of health hazards in their daily work. This exposure puts them at risk of acquiring occupational related diseases, including psychological stress, which can lead to mental illness, absenteeism and job dissatisfaction. In view of the potential risks and occupational hazard, a comprehensive health and safety programme for all employees is mandatory to minimize injury among the employees and therefore for the institution to fully harness the potential of its employees. The programme should indicate management goals, objectives and policy implementation, as well as responsibility and accountability for each role player. The aim of this study was to determine the challenges facing health workers regarding the occupational health services (OHS) at Onandjokwe Hospital in Northern Namibia. The objectives of the study were to determine the existing situation relating to the OHS rendered at Onandjokwe Hospital and to explore and describe the perceptions of health workers regarding OHS at the hospital.Methods: The study employed both quantitative and qualitative methodology that included the use of a checklist for collection of quantitative data on evidences of practice of OHS in different departments of the hospital; interviews and focus group discussions for collection of the data on the workers’ perception on OHS in the hospital. Epi-info software version 3.5.1 was used to analyses the quantitative data while Tech’s method of qualitative analysis was used for the qualitative data.Results: The study revealed that the provision of OHS in the hospital was extremely limited. Many key documents guiding the provision of effective OHS were found to be lacking in several hospital departments. Limited training had been conducted and as a result, there was low awareness on OHS among the employees in the hospital. Both management and staff cited lack of key personnel to drive the process as an important impediment to strengthening OHS in the hospital.Conclusions: The main recommendations that arose from the research include the need for the hospital management to comply with the guidelines on Occupational health, acquire and avail key guiding documents for occupational health practice in all the departments; provision of necessary resources for OHS including OHS staff and implementation of OHS programme to safeguard the health of the employees.

Level of fatigue and daytime sleepiness among heavy vehicle drivers in Sri Lanka

Heavy vehicle crash rates are high in Sri Lanka. International studies showed that fatigue and day time sleepiness are linked to heavy vehicle crashes. The aim of this study is to examine the level of fatigue, day time sleepiness and their associated factors among heavy vehicle drivers in Sri Lanka. A descriptive cross-sectional study was carried out in 403 heavy vehicle drivers through an interviewer administered structured questionnaire consisting of the ‘Fatigue Severity Scale’ (FFS) and the ‘Epworth Sleepiness Scale’ (ESS). The mean age of the study sample was 36.5±8.6 years and all were males. They drive an average of 129.03±87.24 km/day. It was found that the mean FFS score in the study participants was 2.43±0.99 and the mean ESS score was 6.57±4.07. Prevalence of fatigue (FSS score ?4) was 8.7% (n=35) and the prevalence of excessive day time sleepiness (EDS) (ESS score ?10) was 14.4% (n=58). Working for non-fixed schedule, married marital status, and working more than 11 hours/day are found to be significant risk factors for being fatigue. Drivers who were having night sleep of less than 6 hours were found to have a higher risk of EDS. A high prevalence of fatigue (8.7%) and EDS (14.4%) among heavy vehicle drivers was found which may link to heavy vehicle crashes. The occupational health service providers should be aware of the possibility of fatigue and daytime sleepiness in heavy vehicle drivers and its overall risk on the roads to take neces-sary actions.DOI: http://dx.doi.org/10.3329/seajph.v4i1.21832 South East Asia Journal of Public Health Vol.4(1) 2014: 9-16

Occupational Health Challenges of Railway Employees in India ? Towards Developing a Comprehensive Framework for Action

Provision of occupational health services plays a critical role in employee retention, motivation and job satisfaction. Work related health and safety needs of railway employees in India have not received the due attention. Lack of comprehensive framework for analysis and paucity of scientific literature on the subject is a bottleneck for formulation and implementation of effective policies around the subject. This review paper offers a framework for further consideration of the government. In the first of its kind work, the paper also presents a unique and comprehensive perspective of the responsibilities, contextual factors and emerging priorities with regard to occupational health challenges of railway workers. Opting for a comprehensive occupational health policy, capacity building of key stakeholders, regular supervision, strengthening of information management system and facilitating research and innovation on the subject has the potentiality to pay rich dividends in the long run not only to individual workers but also to the economy and the railway industry.

Successful collaboration between occupational health service providers and client companies: Key factors.

Occupational health services (OHS) are often described as an important resource to reduce work-related diseases and improve the workplace. This paper identifies key factors for successful collaboration between Swedish OHS providers and their client companies. Interviews were carried out with representatives of 15 companies and their OHS providers. The interviews were transcribed and their content analyzed. The results revealed that successful collaboration was highly correlated with six factors. First, the collaboration depends on both parties; ``it takes two to tango''. Second, the company and the OHS provider have a joint commitment to a long-term collaboration. Third, the collaboration is built on frequent contact at different organizational levels. Fourth, the company has a well-structured work environment for occupational health and safety management. Fifth, the OHS provider uses a consultative approach in its prevention and promotion activities. Finally, OHS providers seek to treat the company, not the individual. Our research indicates that a successful collaboration requires both occupational health and safety management (OHSM) within the company and the assistance of a competent OHS provider. A change toward more promotion and prevention services benefits the company, since the occupational health services are better tailored to the company's needs.

Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India.

Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. RESULTS indicate the need for training oriented toward behavioral change and provision of occupational health services.

국내 작업환경측정기관의 측정 및 분석장비 보유실태에 대한 고찰 (II)

Objectives: The aim of this study is to analyze the current status of possession of measurement and analytical instruments at work environment monitoring organizations and their relationships with human resources, including the number of professional engineers and evaluation scores resulting from evaluation programs in 2012. Materials: Data for measurement and analytical instruments were gathered by inspectors who had been assigned by the Korea Occupational Safety and Health Agency(KOSHA) and the Ministry of Employment and Labor(MoEL) during the evaluation program for 2012. Data for 11 monitoring instruments and nice pieces of analytical equipment were collected from 103 organizations. Additional data such as the type of service provides and the number of professional engineers employed were also recorded by the inspectors. Evaluation scores could be acquired from KOSHA. Results: Comprehensive Occupational Health Service Providers showed good operation quality, while University or Hospital Subsidiary and Work Environment Monitoring Organizations recorded relatively poor results. Evaluation scores correlated well with the possession of measurement instruments and human resources for each organization. High yields provided by professional engineers also showed statistically-associated contributions to evaluation scores and monitoring instrument possession. Compared with monitoring instruments, the amount of analytical equipment had little positive impact on organizations' competence. Conclusions: The evaluation results for domestic monitoring organizations revealed that human resources, possession of instruments, and the quality of employees were critical factors for operating the corporations. Each organization should give considerable effort to improving their ability to strengtheninternal quality, resulting in high-yield production for workers and employers by providing improved workplace monitoring services.

Some occupational health hazards among fishermen in Alexandria city

Where the fisherman\'s nature of work consumes much of his time and energy, and this is incompatible with normal family life. The work environment is uncomfortable in most cases, especially with the length of work periods at sea on the surface of the compound as well as isolation for long periods of time away from the external environment. Also, many of them suffer from instability therefore since 1713 fishing has been noted as an occupation with a high risk of occupational hazards. There are many problems that can be taken into account when studying occupational health problems for fishermen. Main problems that have been observed: accidents and injuries, musculoskeletal problems, stress, hearing problems caused by noise and skin burns, so the provision of occupational health services for this category is an urgent need which should be available. Cross-sectional study was conducted on a sample of 124 fishermen who work in Alexandria city, and a control group of other comparable consisting of 130 salesmen working in the same city. Previously prepared questionnaire was conducted on all participants in the search for data collection and the work of an environmental assessment to measure the noise level in the work environment. This study showed a statistically significant difference between the fishermen and control group in different health problems (P

The Lived Experience of Women Returning to Work after Breast Cancer

Breast cancer is a global concern and a common cancer in women. Treatment can involve chemotherapy, surgical intervention with possible radiation therapy. Many breast cancer survivors return to work, even though the availability of health care and occupational health services may be limited. This phenomenological study examined the return to work experience of six breast cancer survivors. In-depth, unstructured interviews were undertaken and analysed using an adapted version of Colaizzi’s (1978) approach. Four themes emerged. Women noted that the impact of their disease on their work continued for some time. Some women gained an inner strength to progress their career on return to work. The provision of occupational health services emerged as a positive influence. These findings have implications for occupational health professionals, particularly the importance of positively supporting women so that the breast cancer return to work experience is fully understood.